A study conducted in Israel sought to delineate the mental mechanisms underpinning the increased propensity of patients with ADHD to engage in risky behaviours. The results revealed that ADHD-associated risk-taking is explained by an exaggerated perception of positive outcomes of such behaviour, rather than by a liking for risk-seeking.
Participants (n=244; mean age=34.24 years) were administered a demographic questionnaire to collect information on background, age, gender and history of diagnosis with ADHD, in addition to the Adult ADHD Self-Report Scale (ASRS) to score their ADHD symptoms based on the frequency of their occurrence. Further to this, enrolled subjects completed the Domain-Specific Risk-Taking (DOSPERT) Scale, which assesses risk-taking, benefit-perception and risk-perception in 30 different activities categorised into five different domains.* The risk/benefit attitude, which refers to the extent the subject is attracted or repelled by the perceived risk/benefit of a situation, was derived based on a regression equation.
Male and younger subjects demonstrated higher risk-taking and benefit-perception compared with female and older participants, respectively. Whereas the degree of engagement in risky situations was positively correlated with benefit-perception, there was a negative correlation between risk-taking and perception of risk on the DOSPERT scale.
ASRS scores were positively correlated with the degree of risk-taking and perception of benefit, but demonstrated a negative correlation with levels of perceived-benefit attitude. There was no correlation between ASRS scores and the levels of risk-perception and perceived-risk attitude. A similar trend was observed in the correlation between inattention and hyperactivity scores with the DOSPERT scores.
Mediation analysis revealed that the association between ADHD symptoms and risk-taking was mediated by benefit-perception and perceived-benefit attitude (p<0.05). When specific risk domains were considered, ASRS scores positively correlated with levels of risk-taking and benefit-perception in health/safety, recreation, finance and ethics domains, but such correlation was not evident with levels of risk-perception.
The narrow age distribution and the bias towards highly educated individuals in the study population are limitations of this study. Other limitations are the measurement of hypothetical risk rather than actual engagement in risky behaviour, and the reliance on self-report to validate the engagement in risky situations. Nevertheless, the findings may still assist in guiding ADHD management strategies that consider the perceptions of patients regarding the benefits of risky activities, and may help develop a more reflective thinking construct that reduces the tendency of adults with ADHD to partake in such activities.
Read more about the determinants of risky behaviour among adults with ADHD here
*Health/safety, finance, ethical choices, social interaction and recreation
Shoham R, Sonuga-Barke EJ, Aloni H, et al. ADHD-associated risk taking is linked to exaggerated views of the benefits of positive outcomes. Sci Rep 2016; 6: 34833.